Gums: Gum Disease, Gingivitis and Periodontitis

Oops, I’m here again, Wagner Munhoz, for the third video in the series, where I’m teaching you some tips, that are very important for the good health of your teeth and gums. With these guidelines, if you put them into practice, I’m sure that you will start getting the means to maintain your mouth health well, and you will surely save a lot of money with future dental treatment. In this video, I’ll talk about gum diseases, giving you valuable information for your control. I hope you enjoy it well ! in the last video, I told you a little about dental caries; why it occurs, how to prevent it from developing and what treatments are indicated to rehabilitate the tooth that was affected by it. In this video, I will tell you a little about the diseases that can affect the gum, and tooth support regions. During my life, even when I was a very young child, I remember very well, that I saw many well-known people some of them even relatives of mine, who thought it was normal for their gums to bleed, for the teeth to become movable or even to be lost. I saw a lot of people get toothless or, worse, suddenly toothless without knowing why… Deep down, it was normal… The gums bleed because is a fragile skin! Losing your teeth as you get older is normal ! All wrong thoughts! And I, if I had not graduated as a dentist and often listening to these phrases, it could be until I thought the same way. Just to give you an idea, when I was a teenager, I saw that my gums began to bleed and I didn’t know say why… Maybe, I would be the next ball; condemned, over the years, to lose my teeth due to ignorance of the disease I was suffering from… But, by pure divine inspiration, I graduated in dentistry, and finally succeeded understand very well why these people’s gums bleed; why their teeth became mobile, and why they ended up losing their teeth, because of gum problems. And I have to say something very important to you. I didn’t need to have a degree in dentistry to understand everything I need to know to prevent gums bleeding and tooth loss from gum deseases. Just a few basic skills, which I will briefly tell you in this video, so that you can perfectly avoid the vast majority of gum problems. In other upcoming videos, I could go into more detail about this theme. First of all, I would like to show you a typical example of diseases that affect the gums, also known as gingivitis. And also those that affect, besides the gum, the tooth suport regions, also known as periodontitis. But, before going deep into this topic, I’d like to make one important point: I’d like to speak only of aesthetics and well-being; I would not talk about diseases! On the other hand, I see in my daily life, countless people who had beautiful smiles, and who gradually lost them due to the simple ignorance of these diseases that affect the teeth and gums. And this often deprives them of a better aesthetic, self-esteem, well-being and good social relationships. Take a look at what I said to you now: it is not the diseases themselves that cause all these disorders for the person, but the simple ignorance of these diseases on the part of the person. So, I find it important to pass this knowledge, if not to you, at least to someone close to you, who might be in need of it. So, see you a little overview of these gum diseases. Popularly, these deseases are said to be “gum diseases”. Technically, we, dentists, say that these diseases are called “periodontal diseases”. IE, “Perio” means “around”; and “odonto” means “tooth”. Rather, the term means those “diseases that attack the regions around the tooth which are responsible for the support, protection, and attachment of the tooth in the mouth”. Here in this video, I will use the simplest term, “gum deseases”, in order to facilitate my communication with you. Without fear of making a mistake, both tooth decay and gum diseases are the main causes of tooth loss in the general population and, as I said to you in the last video, both deseases are the most attacking people in the world.
More than 90% are attacked by these diseases! it’s not hard to conclude that millions of teeth are annually lost because of these diseases. Like tooth decay, gum diseases are caused by bacteria present in bacterial plaque. These bacteria in plaque can attack the gums and tooth support structures, leading to the popularly known “gum diseases”. When these bacteria attack only the gums, the person gets a disease called “gingivitis”. When aggression is most severe, and bacteria also attack the tooth supporting structures, a disease known as “periodontitis” forms. Let’s talk about gingivitis and periodontitis in a moment. First, I’d like to tell you a little about the gum and the tooth support structures. See this example: we can see that there is the tooth, formed by its crown and root. The crown serves to chew food and aids in speech. The root serves to fix the tooth, so that it does not fall from the person’s mouth. To do so, the root must be surrounded by bone and ligament. In turn, the gum, which covers the root, bone and periodontal ligament, serves primarily to protect these structures from food intake during chewing. The gum and tooth support structures together form the “periodontium”. The gum, as I said, “protects”. The root, bone and periodontal ligament hold, fix tooth in position. The key to understanding how these structures can be attacked by bacteria in plaque is to know that there is a gap between the tooth and the gum, that surrounds the entire crown of the tooth. This cleft is called a “gingival sulcus” or “gingival cleft”. And it’s exactly on the edge of the gum and in the gingival sulcus, that the bacteria lodge, they “live” and, once there, cause gums diseases. In fact, plaque begins to form just on the edge of the gum and spreads to the regions between one tooth and the other, forming the shape of a letter “U”. Not being removed by hygienic techniques, plaque increases in area and thickness, and begins to creep into the gingival sulcus. There is also the possibility of of tartar formation. Whitin a few days, if this plaque is already mature and already established in the region is not removed by daily hygiene techniques, the gum begins to show the first signs of the disease.
It’s gingivitis! And what are the signs of the presence of gingivitis?
In other words, how can you tell if you have gingivitis? First:
Gum bleeding for no apparent cause or reason.
This can occur during habitual brushing, flossing, eating an apple, or even spontaneously.
Second: swelling. The gum is chubby like a pillow. Third: redness.
The gum forgive its natural color, that is pinkish and becomes a reddish color.
Fourth: in some cases pus is present, especially when the person puts light pressure on the diseased gum region.
There is also often the appearance of halitosis, ie, bad breath. You see that I did not mention the presence of pain or tenderness.
Really, gum with gingivitis and also periodontitis, as you will see, hardly hurts. The presence of pain in this disease very rare. In general, gum with gingivitis bleeds, swells and turns red, but it hardly hurts. Honestly, I tell you, I would prefer gingivitis to cause pain in the person, because then he or she would immediately seek help from the dentist for her solution.
But, on the contrary, since it does not hurt, the disease remain for months, years or decades without a solution to this problem.
On the contrary, once gingivitis persists, one comes to believe that it is perfectly normal that, for example, the gum has bleeding… …what is not true!
Periodontitis is a more severe and advanced case of the disease.
In periodontitis, bacteria do not simply attack the gum, just as it does in gingivitis, but they advance deep and begin to affect the root, ligament, and supporting bone of the tooth. The most striking aspect of the presence of periodontitis is the progressive loss of bone that supports the tooth.
Often the dentist, and also you, can recognize this loss of supporting bone just by looking closely.
In this look, one can recognize an apparent retraction of the inflamed gum and consequent exposure of the tooth root.
But, at other times, bone loss cannot be observed only visually, but a more refined examination of the dentist is necessary to detect it. This is because, there are cases where bone is quietly lost under the gum. In other words, there is no retraction of the gum, so it covers the lost of the supporting bone of the tooth that is running under it.
In this case, the examination of bone loss is achieved through this instrument: It is called a “periodontal probe”.
The exam is basically painless.
The dentist place this probe into the gingival sulcus of the person’s various teeth to check for any bone loss. The deeper this probe penetrates into the gingival sulcus, the greater the bone loss found.
Therefore, this probe has markings, each one represents 1 millimeter.
In a normal gum, this probe penetrates up to 2 millimeters. When bone loss due to periodontitis is found, the probe can penetrate more than 10 millimeters! So, just to summarize, in periodontitis, spontaneous bleeding or during a light touch of the gum occurs; inflammation of the gums, that is, as with gingivitis, the gums become red and swollen; and in periodontitis tooth support bone loss occurs with or without retraction of the gum associated with the tooth.
Often, pus comes out of the gum, when we gently press it.
Periodontitis is often a cause of breath problems in the person.
But the striking sign of periodontitis is that, because of the progressive loss of tooth support bone, occurs, the progressive increase in tooth mobility.
In some more severe cases, the tooth simply detaches itself from the person’s mouth!
Periodontitis, as it happens in gingivitis, hardly causes pain in the person.
And that’s bad because the disease progresses, and the person doesn’t realize it.
Incidentally, if I asked you how long you believe it would take a person’s gum to go from normal to severe periodontitis, what would you answer me?
One week? One month? One year? Five years? Ten years? Twenty years? The right answer, do you know what it is? “whole life” !
For some people, earlier;
For others, later.
But, in general, the whole life, that is, several decades.
The process usually begins in adolescence and the gums bleed and bone loss progressively occurs. When the person reaches the beginning of old age, generally the picture is already severe.
Control for these gum diseases is almost entirely based on daily removal of plaque from the gingival margin and also from within the gingival sulcus. For this, a good oral hygiene technique with flossing and brushing is required daily, with some specific technical details. Follow-up by your dentist is critical, especially if there is tartar and loss of supporting bone in your teeth.
But, very importantly, I tell you this after decades of professional experience, that no gum treatment, no matter how good, really works if the person is unaware of these details that I mentioned in this video, and also they don’t have one some technical detail in your mouth hygiene. During the Orofacial Project, I will talk a little more about hygiene techniques, and also promote a more complete course for people who need more refined Oral Care.
I hope you enjoyed this video just as I enjoyed filming it. Please, leave your comment below.
A big hug!

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